Editorial Comment to A rare case of a testicular lesion related to hand, foot, and mouth disease

This case report demonstrated that coxsackievirus viral orchitis showed an intratesticular mass, resembling testicular cancer.¹ After ruling out testicular cancer, the authors selected a watchful waiting policy for this situation. However, it is very difficult to make a diagnosis correctly without a biopsy or excision. Although viral particles can invade the testis parenchyma through the blood–testis barrier, viral orchitis shows different findings on ultrasound in the testis, as opposed to bacterial epididymo-orchitis. While mumps orchitis showed a homogeneous and or diffused pattern on the ultrasound exam, coxsackievirus orchitis showed a heterogeneous mass in the affected testicles. It is very difficult to tell the difference between malignant and benign conditions. If the wait-and-see policy is selected, both testicles should be monitored carefully. The authors showed the changes in the ultrasound findings over some time. The intratesticular mass finally disappeared after half a year of observation. Additionally, symptomatic therapy such as cooling is essential to prevent testis atrophy. This case report is very important for the readers of the IJU case report. Urologists should know and keep in mind the ultrasound findings of viral orchitis when ruling out testicular neoplasm.

The author declare no conflict of interest.